Long-Term Outcomes of TEVAR for Thoracic Aortic Diseases: A Retrospective Single-Center Study

Abstract

Background: Long-term outcomes of TEVAR for different aortic pathologies are still debated for years. The procedural success and outcomes differ by comorbidities and thoracic aortic pathologies. Therefore, we present our ten-year experience, encountered rare complications, and long-term results. Methods: Between 2006 to 2018, 97 patients underwent endovascular treatment for several indications. The primary endpoints are to explore the leading mortality causes, complications, and reinterventions, evaluate the effects of comorbidities on survival, and compare several indications with survival curves. The second is to investigate rare complications and graft durability in long-term follow-ups. Results: The most indication was thoracic aortic aneurysm (n=52). Ten patients had aortic arch variations and anomalies, and the bovine arch was observed in 8 patients. Endoleaks were the main encountered complication, and 10 of 15 endoleaks were type 1 endoleak. Total reinvention was 18, and the most intervention was reTEVAR (n=5). Overall mortality was 20, and TEVAR-related death mortality was 12. Multivariant Cox regression revealed chronic renal diseases (OR=11.73; 95% CI:2.04-67.2; p=0.006), previous cardiac operation (OR:14.26; 95% CI: 1.59-127.36; p=0.01), chronic obstructive pulmonary diseases (OR:7.82; 95% CI: 1.43-42.78; p=0.001) to be an independent risk factor for 10-year-survival. There was no significant difference in the Kaplan-Maier survival curves of different aortic pathologies. Conclusion: In long-term follow-ups, comorbid factors could independently be risk factors for mortality; however, there is no significant difference in endoleaks occurrence. TEVAR is a suitable solution for severe aortic pathologies with similar outcomes. Graft thrombosis in years should be a question on graft durability.